tv Senator Cornyn on Republican Affordable Care Act Replacement Bill CSPAN July 13, 2017 11:40am-12:00pm EDT
let's do that. let's stick on the high cost of pharmaceuticals. these four things we could do together and the country would love to see democrats andtem republicans working together to make our health care system work better. that's exactly what we should be doing in representing the citizens of the united states o: america. in we the people democratic republic. thank you, mr. president. >> mr. president, as we continue to discuss the better care act, which is an alternative bill that we will propose next week and vote on, that takes a disaster known as obamacare which for millions of americans has lik led to skyhigh premiumsd unaffordable deductibles come ie they can even find an insurance company that will sell them an insurance product, we willca propose a better care act as we call it, not a perfect care act but a better care act.
would be even better if our democratic colleagues would joi' us and work with us in this effort. but as we've come to find out, they are unwilling to acknowledge the failures of obamacare and so we are forced to do this without their assistance. it would be better if it were bipartisan, if they would work with us, but they've made it very clear that they are not interested in changing the broken structure of obamacare. t and what i predict is that what they would offer is an insurance company bailout throwing perhaps hundreds of billions of dollars at insurance companies in order ob to sustain a broken obamacare that will never work no matter how much money you throw at it. so people will continue toto suffer from the failures of obamacare unless we will have the courage to step forward and to save we're going to do the very best we can with the tough hand we've been dealt to help
save the american people who are being hurt right now. invol and basically there are four principles involved. one is we want to stabilize the individual insurance market which is on is the one that inse companies are playing now because they are bleeding red ink. they can't make any money and they are tired of losing money so they basically pick up, pull the roots up and leave town, and leaving customers in the lurch. secondly, we want to make sure we actually lower insurance bill premiums. under the original discussionnt draft bill that we introduced about a week or so ago the congressional budget office said you will see premiums go down as much as 30% over time. now i wish i could say we're going to be able to have anut immediate effect on those premiums but the truth is this is much better than our friends across the aisle have offered us
with, offer to basically sustain a broken obamacare system. the third thing we want to do is protect people who might have their health insurance hurt or impeded by pre-existing conditions. we want to maintain the current law so people are protected when they leave their work or when they change jobs. and the fourth is we want to put medicaid on a sustainable path. medicaid is one of the three major entitlement programs, and now we spend roughly $400 billion on medicaid in this country. our friends across the aisle don't want to do anything that would keep that from growingps higher and higher and higher to the point where basically the system collapses. we believe that's not responsible choice. so what we have proposed is to spend $71 billion more on medicaid over the budget window and to work to transition though
states that it expanded medicaid and offer their people a better option in the private insurance area. but i just want to mention, i should a number of stories about, for example, a small business owner who was forced to fire their employees so they could afford to keep the doors open and provide health insurance to the remaining lead people. you have to ask what in the world could lead us to a system which would discourage people from hiring more folks and basically put them in a positior where they had to fire them in order to make ends meet.er but that's what the employer mandate did under obamacare. if you have more than 50 employees you are subject to the employer mandate come you get punished unless you make sure that your employees are covered with insurance. many times it's unaffordable. so it is have the perverse
impact of small businesses saying well, we can afford to grow the number of people who are working in our business ork we will need to shrink it just in order to avoid that penalty. so stories like this reminded just how important our efforts are to repeal and replace obamacare. the status quo is not working. in fact, every year obamacare gets worse for the millions in the individual market in particular. but it's important that obamacare is not just about insurance. obamacare is about penalties that are being imposed on businesses that hurt their ability to grow and create jobs. that's one reason i believe since the great recession of 2008 where ordinarily you would see a sharp bounce up in the economy, that the economy has been largely flat and has not been growing. in part because the penalties ig the mandates and the regulation associate with obamacare.
not only is obamacare make health insurance more expensive while taking away choices, it's also compounded fundamental problems with important safety net programs like medicaid. i want to share a story from an emergency room employee who wrote me about the alarming trend she's noticed in the hospital where she works she said because fewer and fewer physicians will see a medicaid patient, she is seen an influx of these medicaid patients who ostensibly have coverage coming to the emergency room for their primary care. as she points out this is not a good situation for patients and hospitals.,ng to in my state, according to the latest survey, the texas medical association that i've seen only 31% of doctors in texas will see a new medicaid patient.in that may sound crazy but let me explain why. because medicaid basically pays a position about half of what
private insurance pays when it comes to see a patient pick many of them simply say i can't afford to see a lot of medicaid patients i need to balance about or at least make sure i see in a private insurance patients to make sure i can keep the doors open and meet my obligations. s but what happens when fewer and fewer doctors actually see medicaid patient is about people end up showing up in thema emergency room for their primaro care because they can't find a doctor to see them, and then truth is the medical outcomesve based on many studies have been done in recent years are that medicaid coverage in dust instances can be no worse and no better than having come not having insurance at all. obamacare was put in place ostensibly to avoid reliance on emergency rooms for access to care but as we all know obamacare hasn't lived up to many of its promises and, unfortunately, making stories
like this one commonplace. i mentioned this earlier but just to see the trend line, in t 2067% texas physicians accept new medicaid patient. today that never stood for%. i think ma said 31%. it is 34%. due 4%. due to low rates of providerng reimbursement, leaving patients the places like lake granbury in the lurch and causing them to have to turn the emergency roomn whether primary care as a last resort. well, every two years texas doctors fight with the texas legislature to raise payments for the medicaid system but the reality is there's not enough e money to go around even though it's the number one or number two budget item in the texas legislatures budget every year. it's growing so fast it is god in everything from higher education to law enforcement and other priorities.d across the country medicaid spending has ballooned out of control.
in texas, 25% of the states budget as indicated is dedicated to this program. 25% of its overall budget future number one or number two. we have it to be honest with ourselves and the people we represent that this situation is not sustainable. we owe it to the millions of people to make sure that medicaid, the people who really need it, the fragile elderly, disabled, adults and children that it is there for them. not only now but in the future. ways we might strengthen the sustainability of medicaid and ensure the families who actually needed can rely on it. they don't have the rug pulled out from under them. but this required doing some hard work of reforming the way that states handle medicaid funding. for example, medicaid as it is currently applied state are only allowed to review the list of medicaid recipients once a yeart
but a lot can happen in a period of you pick somebody can get a job. they may no longer be eligible based on the income qualifications for medicaid, but if you could only check once a year that people remained on the roles even though they no longer qualify. so regardless of whether somebody gets a job or moves or passes away or no longer needs medicaid, they are still in the system and there's nothing the states can do about it. we would like to change that. while it sounds like a simple matter when the average medicaid patient costs the state more than $9000 each and si is almost $12,000 per elderly individuals, it adds up. one of the things we saw that obamacare did in the states that expanded medicaid coverage is those dates decided to cover single adults who are capable o, working.o
well, what this bill would also do would be to allow the states to experiment with the work required as part of the eligibility for medicaid. we are not mandating it, but if the state chooses to do it, then they can do so. we need to give the states the flexibility they need so they can use the medicaid funding that they have more efficiently and so more people can get access to quality care. i want to be clear. 4.7 million texans rely on medicaid.en of course those roles came to churn based on peoples employment and the family circumstance but it's not going anywhere. we want to make sure we preserve medicaid for the people who actually need it the most. we are working to make itie stronger, more efficient and yem more sustainable.e i guess some people live in a fantasy world where they think we can continue to spend money we don't have an there will
never be any consequences associated with it. the fastest items of spending on the federal budget are another programs including medicaid. right now we at about $20 trillion. we've done a pretty good job i know we don't get much credit for it, pretty good job of controlling discretionaryre spending which is the 30% of federal spending we appropriatee for the study% amid the tories spending including medicaid have been going up on average about 5.5% here. that can't happen in perpetuity. right now we know we have $20 trillion roughly in debt.nky $20 trillion. it's frankly immoral. for those of us who are adults, today, to spend money borrowed from the next generation and beyond because somebody else will have to pay it back. it's going to real-world re consequences. we know since the great recession the federal reserve has cut interest rates very low
through their monetary policy. but we know as well that as the economy tends to get a little better and unemployed come down they will be inching those interest rates up little by little, which means we're going to end up paying the people that own our debt, our bondholders,on more and more money strictly for the purpose of giving them a return on their investment for so this is an opportunity for us not only to put medicaid on arei sustainable path to do the responsible thing, to give the states ultimate flexibility in terms of how they handle it. it's also a matter of keeping faith with the next generation and beyond when it comes to this unsustainable debt burden. i hear people talk about slashing medicaid despite the fact that the congressional budget office estimates medicaid spending will grow by $71
$71 billion over the next ten years. only in washington, d.c., is that considered a cat. t where spending next year exceeds what it is this year and the next year and so on goes upay $71 billion. you will hear people come to the senate floor and say that i cut and we are slashing medicaid. it's nothing of the kind.r. well, to me the choice is clear. do we want to continue with theo failures of obamacare, or do wep want to do our very best to try to provide better choices and better options? do we want to continue to allow the status quo which is hurting families putting a strain on doctors and our emergency rooms and hospitals like i mentioned or do we want to address the fundamental flaws of our health care system? i i wish we do something perfect but certainly with the not constraints imposed by the fact our democratic friends are not willing to lift a finger to help
and given the fact that we have to do this using the budget process, those are some pretty serious constraints. we basically have to do this with one arm tied behind our weecause but we're going to do the best we can because we owe it to the people we represent. i would encourage our colleagues on both sides of the aisle to try to take a fresh look at this and figure out how to be part of the solution, not just compound the problem. there is one thing that i haven't mentioned that i am particularly excited about int, the better care act, and that is for states like texas that did not expand medicaid to cover able-bodied adults in the 100-138% of federal poverty level. what we have done in the better care act is provide them access to private health insurance and coverage for the first time. it's about 600,000 texans, low-income texans who for the
first time under the provisions of this bill will have access to a tax credit, and the statend using the innovation and stability fund and something called section 133 1332 waiversl be able to design programs whici will make health care more affordable in the private insurance market. one reason people prefer the private insurance market to medicaid is for the reason i mentioned earlier. that medicaid reimburses health care providers about 50 cents oa the dollar compared to private health insurance. so this action will provide them more access to more choices than they have now, certainly for didn 100-one and 38% in those states that states that didn't expand.t so i'm excited about what we're trying to do and its potential. again, to stabilize the markets which are in meltdown mode right
now, and we all know are unsustainable. a friend across the aisle say wl will talk to you if you take all the reforms off the table which translates to me, will talk to you about bailing out a bunch of insurance companies but doing nothing to solve the basic underlying pathology in the system. so we're going to do that in our secondly we want to make sure we do everything in our power to o bring down premiums. i know the presiding officer cares passionately about this. this may well be the litmus test for our success. the cbo has said under the draft discussion, discussion draft wea released earlier in the surgery can see premiums as much as 30% lower but we would like to see even more choices and premiums lower than that and more affordable. the third thing, are better care act will do, it will protect people against pre-existing conditions. right now people sometimes refused to or afraid to leave
their job in search of another job because if they have a pre-existing condition and they can't get coverage with their new insurance company for a period of time. that's called the pre-existing conditions exclusion. we would like to protect people against that eventuality so that people don't have to be worried about changing jobs or losing their job and losing their coverage. and forth as i've taken a few minutes to talk about here today you want to put medicaid one of the most important safety net programs in the federal government on a sustainable path. one that is fair to the states that both expand medicaid under the affordable care act and those that did not. and you need fair-minded person looking at what we have proposed would agree with me it's not perfect but it is certainly fits the name we ascribe to it. it is a better alternative than people have under the status quo. so i would urge all of our
colleagues to work with us in to good faith to try to improve itw and here's the best news of all perhaps to those who would have other ideas. we do have an opportunity to have an open amendment process. sometimes that doesn't happen around here, and people sick here it is, take it or leave it. can't change it all you can do is vote for or against it. that's not what we're going to do. we are going to have an open amendment process, so as long as senators have the energy to stay on their feet and offeres amendments, they can get votes on those amendments. i can't think of a better way to reflect the will of the senate and to come up with a very best product we can under the t circumstances. so we are on a trajectory next week to begin this process, and probably some very late nights and early mornings, thursday ani friday. flo